donaleen and Ozy
Member Since 2013
Please look at his SS (attached to signature) and see what you think. How often should I be testing him? He dropped from 194 to 108 in three hours. I am a little scared.
7/26 Ozy AMPS-195, +3-108, +4-154 +11-347 PMPS-333 +2-309
- Thread starter donaleen and Ozy
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Alexis & Nikki (GA)
Member Since 2013
Re: Ozy down to 108
Hi, I haven't been around long enough to advise, but you might want to edit your subject to note that you are looking for an advisor's help. That way you'll get some eyes on your ss and some help.
I'd definitely feed a couple teaspoons of LC to slow the drop a bit for the time being. Good luck!
Hi, I haven't been around long enough to advise, but you might want to edit your subject to note that you are looking for an advisor's help. That way you'll get some eyes on your ss and some help.
I'd definitely feed a couple teaspoons of LC to slow the drop a bit for the time being. Good luck!
donaleen and Ozy
Member Since 2013
Re: Ozy down to 108
Back up to 178 half an hour later. Seems like a big jump. Should I trust my readings?
Back up to 178 half an hour later. Seems like a big jump. Should I trust my readings?
Alexis & Nikki (GA)
Member Since 2013
Re: Ozy down to 108
I sent Marje a PM to look in on you. Help is on the way!
I sent Marje a PM to look in on you. Help is on the way!
Re: Ozy down to 108
Hang on just a second and let me look at his SS, ok? Don't worry...he's at safe numbers
BRB.
Hang on just a second and let me look at his SS, ok? Don't worry...he's at safe numbers
BRB.
Re: Ozy down to 108
I'd go ahead and retest. Yes, numbers can jump that high that fast if the liver reacts. Did you feed him at the 108?
A couple things that would help us is if you can put in the Remarks section what you feed. Many members will put an asterisk in the column when they feed (for example, if they feed at AMPS and +1, they put an asterisk in each block to show they fed). But it also helps us if we know if you fed anything out of the usual like high carb.
And to get our attention, if you want to put your subject line something like the rest of us, for example:
7/25 Ozy AMPS 195 +3 108 Help pls
There are some of us scanning the board for changes in numbers, etc.
I'd go ahead and retest. Yes, numbers can jump that high that fast if the liver reacts. Did you feed him at the 108?
A couple things that would help us is if you can put in the Remarks section what you feed. Many members will put an asterisk in the column when they feed (for example, if they feed at AMPS and +1, they put an asterisk in each block to show they fed). But it also helps us if we know if you fed anything out of the usual like high carb.
And to get our attention, if you want to put your subject line something like the rest of us, for example:
7/25 Ozy AMPS 195 +3 108 Help pls
There are some of us scanning the board for changes in numbers, etc.
donaleen and Ozy
Member Since 2013
Re: Ozy down to 108 pls help number jumping around
Thank you for the responses... he is at 154 at AMPS+4
He eats very often...at least four times a day, small frequent meals. He eats Wellness grain free turkey and salmon, mostly. I supplement with real cooked meat and chicken broth, usually in the middle part of the day. Today he gets a small ground lamb patty, cooked. His real meat is the same high quality meat we eat. He loves real meat. He has been on this food regime for nine months, well before he was diagnosed with diabetes. He was diagnosed with pancreatitis three years ago (from steroids) and the food he eats is based on finding what he got along with best and what I hope is high quality food.
This morning I got up at six and checked his glucose (it was 260, before he ate). I fed him, and at 7:30 am checked again before his insulin and it was at 195. Why did it go down when he had food? These jumping around numbers don't make sense to me. I don't trust that I know when his nadir is. The vet says I am testing more than I need to. I explained I am looking for the nadir so I can know how to adjust the dose.
I thought I was doing well with all this. Apparently not.
Thank you for the responses... he is at 154 at AMPS+4
He eats very often...at least four times a day, small frequent meals. He eats Wellness grain free turkey and salmon, mostly. I supplement with real cooked meat and chicken broth, usually in the middle part of the day. Today he gets a small ground lamb patty, cooked. His real meat is the same high quality meat we eat. He loves real meat. He has been on this food regime for nine months, well before he was diagnosed with diabetes. He was diagnosed with pancreatitis three years ago (from steroids) and the food he eats is based on finding what he got along with best and what I hope is high quality food.
This morning I got up at six and checked his glucose (it was 260, before he ate). I fed him, and at 7:30 am checked again before his insulin and it was at 195. Why did it go down when he had food? These jumping around numbers don't make sense to me. I don't trust that I know when his nadir is. The vet says I am testing more than I need to. I explained I am looking for the nadir so I can know how to adjust the dose.
I thought I was doing well with all this. Apparently not.
Re: Ozy down to 108
When they clear bounces, the numbers tend to come down even if you feed. You can, perhaps, slow the rate of descent. It looks to me like he's just flat right now because 178 and 154 are within the 20% meter variance of each other. But he might continue to slide all the way down into PMPS.
It's good to get a general idea of nadir but nadirs can change and quite often, cycles are not "typical" lantus cycles. Sometimes they start to clear a bounce and then it's almost like the liver decides it's not quite done bouncing and numbers go back up unexpectedly. One of the hardest things to learn is that you are just along for the ride as much as we want to control the sugardance, you just have to follow his lead. Yes, we can manage the curve with food. But as you saw, sometimes it works as we expect, sometimes it doesn't.
I would try to not feed him within two hours of his shot because we don't want to take the chance of an inflated preshot number (because it is influenced by food). While many free feed their cats, just know that if you do, feeding after nadir also can slow down the effects of the insulin. Lantus and Levemir are known for their nice, long durations and carryover/overlap. If you feed after the peak action of the insulin, you might diminish the duration. You can see how he responds; as I said, many free feed and feed after nadir.
You all haven't been doing this long so don't rush to be hard on yourself. You are doing just fine. It takes time to build data to know his onset, nadir, and duration. And those are also difficult to see in bounce clearing cycles. The majority of vets say we test too much. I test to keep my kitty safe.
When they clear bounces, the numbers tend to come down even if you feed. You can, perhaps, slow the rate of descent. It looks to me like he's just flat right now because 178 and 154 are within the 20% meter variance of each other. But he might continue to slide all the way down into PMPS.
It's good to get a general idea of nadir but nadirs can change and quite often, cycles are not "typical" lantus cycles. Sometimes they start to clear a bounce and then it's almost like the liver decides it's not quite done bouncing and numbers go back up unexpectedly. One of the hardest things to learn is that you are just along for the ride
as much as we want to control the sugardance, you just have to follow his lead. Yes, we can manage the curve with food. But as you saw, sometimes it works as we expect, sometimes it doesn't.I would try to not feed him within two hours of his shot because we don't want to take the chance of an inflated preshot number (because it is influenced by food). While many free feed their cats, just know that if you do, feeding after nadir also can slow down the effects of the insulin. Lantus and Levemir are known for their nice, long durations and carryover/overlap. If you feed after the peak action of the insulin, you might diminish the duration. You can see how he responds; as I said, many free feed and feed after nadir.
You all haven't been doing this long so don't rush to be hard on yourself. You are doing just fine. It takes time to build data to know his onset, nadir, and duration. And those are also difficult to see in bounce clearing cycles. The majority of vets say we test too much. I test to keep my kitty safe.
Alexis & Nikki (GA)
Member Since 2013
Re: Ozy down to 108
I think you are doing a great job! My vet doesn't believe in testing. I might just show him the 36 Nikki gave me this morning as proof that testing is good! I don't know what might've happened had I not tested and given her insulin. ohmygod_smile
I think you are doing a great job! My vet doesn't believe in testing. I might just show him the 36 Nikki gave me this morning as proof that testing is good! I don't know what might've happened had I not tested and given her insulin. ohmygod_smile
donaleen and Ozy
Member Since 2013
Re: Ozy down to 108
Thanks. I really am trying hard but all too often, I read another piece of information and it all starts to sound like blah blah blah blah. I am still having trouble with when to feed, when to test, how to interpret the numbers
So when should I feed him? Not within two hours before his insulin? When is the peak action that I shouldn't feed after? I am not understanding how to do this. I am lucky to be at home and to work from home. But today I feel like I don't know what I am doing. I can test. But what do I with the numbers? I am feeling very dense.
Thanks. I really am trying hard but all too often, I read another piece of information and it all starts to sound like blah blah blah blah. I am still having trouble with when to feed, when to test, how to interpret the numbers
Marje and Gracie said:
So when should I feed him? Not within two hours before his insulin? When is the peak action that I shouldn't feed after? I am not understanding how to do this. I am lucky to be at home and to work from home. But today I feel like I don't know what I am doing. I can test. But what do I with the numbers? I am feeling very dense.
Re: Ozy down to 108
Most of us feed at the time we give the shot. Then between the shot and nadir (which varies by cat), you will have to experiment. For cats that tend to dive early in the cycle, members have their cats on a feeding schedule like feeding at preshot (PS), +1, +2, +3 or some variation thereof because it balances the onset of the insulin. Some have modified schedules for feeding; some free feed their cats up until two hours prior to shot time. Because every cat is different (ECID), you have to learn what works best for Ozy because what works best for my cat, might not work best for yours. Obviously, if he starts to develop some characteristic patterns of early drops, you'll want some kind of a front loaded feeding schedule. But we still need to see if he's going to do that or if today was just an anomaly.
Insofar as testing, you should always get a PS test and Sienne and I are big believers in getting a +2 test as often as you can. Lantus typically onsets at +2 so if the +2 test is much greater than the PS, it's likely to be an inactive cycle; if it's the same or similar to the PS, it's likely to be an active lantus cycle (see below); if it is much less than the PS, you are probably going to be very busy and will need to test more based on what the numbers tell you. A mid-cycle test is helpful; and the +10/+11 tests tell you whether Ozy is coming down at PS or going up.
The best way for us to help you is if you can read through the Stickys at the top of the forum and list out your questions; where does it turn to "blah blah blah". You will likely need to read them many times. I still read them over and over. But we can answer your questions if you let us know exactly what is confusing you.
This is overwhelming at first; the good thing is we have ALL been there and we understand where you are. It does get easier; you start to understand more. After members have been with us for a month or so, we suggest they go back and read over their first posts and see how very far they've come. We're here to support you and help educate you as well as help you keep Ozy safe as you learn how to manage his FD.
So welcome to Lantus Land and bring on the questions!
Most of us feed at the time we give the shot. Then between the shot and nadir (which varies by cat), you will have to experiment. For cats that tend to dive early in the cycle, members have their cats on a feeding schedule like feeding at preshot (PS), +1, +2, +3 or some variation thereof because it balances the onset of the insulin. Some have modified schedules for feeding; some free feed their cats up until two hours prior to shot time. Because every cat is different (ECID), you have to learn what works best for Ozy because what works best for my cat, might not work best for yours. Obviously, if he starts to develop some characteristic patterns of early drops, you'll want some kind of a front loaded feeding schedule. But we still need to see if he's going to do that or if today was just an anomaly.
Insofar as testing, you should always get a PS test and Sienne and I are big believers in getting a +2 test as often as you can. Lantus typically onsets at +2 so if the +2 test is much greater than the PS, it's likely to be an inactive cycle; if it's the same or similar to the PS, it's likely to be an active lantus cycle (see below); if it is much less than the PS, you are probably going to be very busy and will need to test more based on what the numbers tell you. A mid-cycle test is helpful; and the +10/+11 tests tell you whether Ozy is coming down at PS or going up.
The best way for us to help you is if you can read through the Stickys at the top of the forum and list out your questions; where does it turn to "blah blah blah". You will likely need to read them many times. I still read them over and over. But we can answer your questions if you let us know exactly what is confusing you.
This is overwhelming at first; the good thing is we have ALL been there and we understand where you are. It does get easier; you start to understand more. After members have been with us for a month or so, we suggest they go back and read over their first posts and see how very far they've come. We're here to support you and help educate you as well as help you keep Ozy safe as you learn how to manage his FD.
So welcome to Lantus Land and bring on the questions!
donaleen and Ozy
Member Since 2013
Re: Ozy down to 108
I have read all those sticky notes. Many times. I think I have it and then I find some other bit that throws it all up in the air.
Let's just start with the great replies you gave me today.
What is an inactive cycle? Why would a cycle be inactive?
It looks like his nadir for this cycle may have been at +3. Why would that be? Does that mean that Lantus doesn't last very long with him?
It seems like there are so many variables that it is hard to know what to do. Although I want his numbers to drop, I get scared if they drop quickly (like they did today). Especially when they drop AFTER he eats. Like this morning, why would they drop from 260 at +10, when I fed him to 195 pre shot?
I also study other cats' SS to see what goes on. Even after a few years of treatment and careful monitoring, the numbers seem wild and crazy.
And if the glucometers vary their readings by that much, how can one make decisions about insulin amounts?
Please look at his sheet. When is his nadir? It seems all over the place to me. Does that mean his body is fighting the low numbers? How do I get past that? Does the body give up fighting?
His numbers are actually pretty good today. And here I am, terrified that I am going to kill him by taking the number too low instead of feeling happy that the numbers are good.
I am not a freak out kind of person. I am good in an emergency. But here, I feel I am on a shaky foundation and I need to understand and respond appropriately.
I have read all those sticky notes. Many times. I think I have it and then I find some other bit that throws it all up in the air.
Let's just start with the great replies you gave me today.
What is an inactive cycle? Why would a cycle be inactive?
It looks like his nadir for this cycle may have been at +3. Why would that be? Does that mean that Lantus doesn't last very long with him?
It seems like there are so many variables that it is hard to know what to do. Although I want his numbers to drop, I get scared if they drop quickly (like they did today). Especially when they drop AFTER he eats. Like this morning, why would they drop from 260 at +10, when I fed him to 195 pre shot?
I also study other cats' SS to see what goes on. Even after a few years of treatment and careful monitoring, the numbers seem wild and crazy.
And if the glucometers vary their readings by that much, how can one make decisions about insulin amounts?
Please look at his sheet. When is his nadir? It seems all over the place to me. Does that mean his body is fighting the low numbers? How do I get past that? Does the body give up fighting?
His numbers are actually pretty good today. And here I am, terrified that I am going to kill him by taking the number too low instead of feeling happy that the numbers are good.
I am not a freak out kind of person. I am good in an emergency. But here, I feel I am on a shaky foundation and I need to understand and respond appropriately.
Re: Ozy down to 108
A request before I answer your questions. Can you format your subject line much like you see on the board?
A request before I answer your questions. Can you format your subject line much like you see on the board?
date cat's name AMPS-#, +time-#
7/26 Ozy AMPS-195, +3-108, +4-154, etc.
This lets us know how Ozy is doing or if we see something you need to be alerted to, we'll let you know. You'll also notice that people will ask for help, note if they have a question, etc. in their subject line. You need to edit the subject lin in the first post in the thread in order for it to appear on the board. 7/26 Ozy AMPS-195, +3-108, +4-154, etc.
A cycle can be inactive for lots of reasons. Your cat may be bouncing and it takes up to 72 hours for a bounce to clear and numbers to come back down. Numbers may, for some inexplicable reason be high and flat. It may be a flat cycle at any number range. You could have given a fur shot and not know it. Ozy could have eaten contraband or been stressed and numbers are high. It could be the moon (I'm only semi-kidding about that.) Your insulin may be old or bad. A cycle can be inactive because you're dealing with a cat and they do not like being predictable.
Ozy's nadir was at +3 today. It's been a +6 on several days. Nadirs can change. They can change as quickly as from cycle to cycle. Gabby's nadir is typically at around +3 or +4 except on days when it isn't. (See comment in bold above for an additional reason.) Because the nadir is early doesn't necessarily effect the duration of Lantus for your cat.
Sometimes, as a bounce is clearing, numbers drop later in the cycle. Also, if you factor in 20% meter variance, the difference between 260 and 195 is not that much. However, it was a dropping number at your AMPS. Numbers can drop after a cat eats. Food stimulates the pancreas to produce and release it's own insulin. This is what happens in a non-diabetic. If a diabetic cat's pancreas is healing, the pancreas may sputter and put out insulin when it's stimulated by food. (See comment in bold above for an additional reason.)
The numbers, at least in most cases, aren't wild and crazy. It takes a while to learn to read and interpret a spreadsheet. And, of course, cat's don't like being predictable so sometimes numbers can be weird because we're dealing with cats.
No matter what instrument you're using -- a glucometer, thermometer, blood pressure cuff, or even a response to a questionnaire -- there is measurement error. (The term is "standard error of measurement.") The number you're seeing is, in essence, an average of all of the possible readings. If you were to get a big drop of blood and test repeatedly, you wouldn't always get the same exact number. Our instruments aren't that precise. We use that "average" that we see on the meter and base our decisions on the numbers we see. If a number seems way off, most of us re-test because it can be a legitimate error of either the meter or the strip.
Nadirs change. It doesn't mean that Oz is fighting the low numbers or the insulin. There are cycles when his nadir is at +6 and times when it's not. It's fine and it's normal.
Re: Ozy down to 108
Sienne must have been reading my mind because I was just headed here to respond to your questions. I'm glad she did.
You've probably read the sticky on the Insulin Depot but it bears reading again now that you have some answers from Sienne. I think it explains alot of what you see on SSs. But....as she said...sometimes it's because they are a cat.
The other thing to keep in mind is that insulin is a hormone, not a medication. I think we all come into this thinking "if I give this much, I'll get this sort of response". But hormones don't work that way.
Does Siennes info and mine help?
Sienne must have been reading my mind because I was just headed here to respond to your questions. I'm glad she did.
You've probably read the sticky on the Insulin Depot but it bears reading again now that you have some answers from Sienne. I think it explains alot of what you see on SSs. But....as she said...sometimes it's because they are a cat.
The other thing to keep in mind is that insulin is a hormone, not a medication. I think we all come into this thinking "if I give this much, I'll get this sort of response". But hormones don't work that way.
Does Siennes info and mine help?
donaleen and Ozy
Member Since 2013
Re: 7/26 Ozy AMPS-195, +3-108, +4-154
Okay, I changed the subject line successfully. I did try before but I changed it on a reply and it didn't fix it. I had to go to the original post to get the change to stick.
Thank you for taking the time to respond. It's good information. But I am still on pins and needles. I feel like the only thing I can do is check him often (every two hours) to be sure he isn't hypoglycemic. And if he is, then he will have a hard time for quite a while stabilizing. So going hypo is a double danger.
Now he has gone up 266.... can I let off testing until his insulin shot time? I think he is well past the nadir. Unless you can have two big dips in a cycle.... I hope not.
I am like that annoying nurse that wakes you up to check your vitals in the hospital. I am constantly waking him up to see how he responds.
Am I even asking questions on the correct board? Lantus Tight Regulation is the protocol I want to follow. Is it okay to ask these questions here or not? I get the feeling I've done this all wrong. I never posted an introduction.
Okay, I changed the subject line successfully. I did try before but I changed it on a reply and it didn't fix it. I had to go to the original post to get the change to stick.
Thank you for taking the time to respond. It's good information. But I am still on pins and needles. I feel like the only thing I can do is check him often (every two hours) to be sure he isn't hypoglycemic. And if he is, then he will have a hard time for quite a while stabilizing. So going hypo is a double danger.
Now he has gone up 266.... can I let off testing until his insulin shot time? I think he is well past the nadir. Unless you can have two big dips in a cycle.... I hope not.
I am like that annoying nurse that wakes you up to check your vitals in the hospital. I am constantly waking him up to see how he responds.
Am I even asking questions on the correct board? Lantus Tight Regulation is the protocol I want to follow. Is it okay to ask these questions here or not? I get the feeling I've done this all wrong. I never posted an introduction.
Re: 7/26 Ozy AMPS-195, +3-108, +4-154
You are more than welcome here. Some people post introductions,, some don't.
Thank you for fixing the subject line.
Clinical hypos on Lantus and levemir are rare. We are all wary of them. But remember you have two big things in your favor: you are testing and you have food to manage the curve when necessary. Be sure you have a variety of low, medium, and high carb foods and karo or pancake syrup. I'd also be sure the HC foods have gravy.
Anytime you get a number that makes you nervous...post and ask for help. There's someone on here almost 24 hours a day. Wendy/Neko and I are usually up at least until midnight PT and Dyana comes on around 5 am ET with Sienne shortly behind her so there might be an hour gap there. If we see numbers going down, one of us stays up to help you or we tag team so you aren't left alone.
You can bump your condo to the top just by opening it, click on "post reply", type "bump" in the text box, click submit. Don't hesitate to bump your condo up if you need help or if it I'd an emergency, use the 911 button.
Keep looking around other condos and SSs. See how others deal with low numbers. I promise, we all know how you feel. My baby girl still likes to throw me a 30 something and I test alot. I take it seriously.
You're doing great....you'll be fine and so will he!
Yes..you can let up on the testing. You might want to get a +11 so you can see what he's doing as he goes into shot time.
Is your name Donaleen?
You are more than welcome here. Some people post introductions,, some don't.
Thank you for fixing the subject line.
Clinical hypos on Lantus and levemir are rare. We are all wary of them. But remember you have two big things in your favor: you are testing and you have food to manage the curve when necessary. Be sure you have a variety of low, medium, and high carb foods and karo or pancake syrup. I'd also be sure the HC foods have gravy.
Anytime you get a number that makes you nervous...post and ask for help. There's someone on here almost 24 hours a day. Wendy/Neko and I are usually up at least until midnight PT and Dyana comes on around 5 am ET with Sienne shortly behind her so there might be an hour gap there. If we see numbers going down, one of us stays up to help you or we tag team so you aren't left alone.
You can bump your condo to the top just by opening it, click on "post reply", type "bump" in the text box, click submit. Don't hesitate to bump your condo up if you need help or if it I'd an emergency, use the 911 button.
Keep looking around other condos and SSs. See how others deal with low numbers. I promise, we all know how you feel. My baby girl still likes to throw me a 30 something and I test alot. I take it seriously.
You're doing great....you'll be fine and so will he!
Yes..you can let up on the testing. You might want to get a +11 so you can see what he's doing as he goes into shot time.
Is your name Donaleen?
Re: 7/26 Ozy AMPS-195, +3-108, +4-154
Lol!! We have all stood in the same shoes that you're wearing. The learning curve at the beginning is HUGE. There is so much to absorb and so many potential places to make a misstep. And we've all made mistakes. The good news is that there are lots of people here who will help you if you do make a mistake or who will steer you away from making one.
There are people like Marje and I who are testaholics. We're at one extreme. You don't have to join our club. In the beginning, more data helps you to understand how Ozy is responding to insulin and begin to grasp his patterns. This takes time, though.
A sidebar on hypoglycemia: It is very rare that a caregiver who is systematically raising their cat's Lantus dose and who is monitoring their cat's progress will cause their cat to have a symptomatic hypoglycemic episode. It's possible, but unlikely. We also differentiate between symptomatic hypoglycemia and low numbers. Gabby has dropped into the 20s and 30s and not been symptomatic. I monitor carefully and know her patterns and I know what to do to get her numbers up. That's why we tell you to have high carb food and some form of syrup (Karo, maple syrup, honey, etc.) on hand in case you need to steer numbers with food. Seeing low numbers is unnerving the first couple of times. We don't let you hang out flapping in the breeze when that happens. As long as your subject line is updated or you ask for help (or post the "911" icon) people will be here to walk you through the process (and remind you to breathe and eat chocolate).
You are in the right place and this is a wonderful place to ask your questions. There is a huge volume of experience and expertise here. If you're asking a question and we think you'll get a more of a response Health, we'll let you know. Our egos aren't that big that we think we can answer every question equally well.
Lol!! We have all stood in the same shoes that you're wearing. The learning curve at the beginning is HUGE. There is so much to absorb and so many potential places to make a misstep. And we've all made mistakes. The good news is that there are lots of people here who will help you if you do make a mistake or who will steer you away from making one.
There are people like Marje and I who are testaholics. We're at one extreme. You don't have to join our club. In the beginning, more data helps you to understand how Ozy is responding to insulin and begin to grasp his patterns. This takes time, though.
A sidebar on hypoglycemia: It is very rare that a caregiver who is systematically raising their cat's Lantus dose and who is monitoring their cat's progress will cause their cat to have a symptomatic hypoglycemic episode. It's possible, but unlikely. We also differentiate between symptomatic hypoglycemia and low numbers. Gabby has dropped into the 20s and 30s and not been symptomatic. I monitor carefully and know her patterns and I know what to do to get her numbers up. That's why we tell you to have high carb food and some form of syrup (Karo, maple syrup, honey, etc.) on hand in case you need to steer numbers with food. Seeing low numbers is unnerving the first couple of times. We don't let you hang out flapping in the breeze when that happens. As long as your subject line is updated or you ask for help (or post the "911" icon) people will be here to walk you through the process (and remind you to breathe and eat chocolate).
You are in the right place and this is a wonderful place to ask your questions. There is a huge volume of experience and expertise here. If you're asking a question and we think you'll get a more of a response Health, we'll let you know. Our egos aren't that big that we think we can answer every question equally well.
donaleen and Ozy
Member Since 2013
Re: 7/26 Ozy AMPS-195, +3-108, +4-154
You guys are great. You made me cry in gratitude.
Yes my name is donaleen (I like it better with the small d....capital D is kind of an ugly letter.
smiling now.
You guys are great. You made me cry in gratitude.
Yes my name is donaleen (I like it better with the small d....capital D is kind of an ugly letter.
smiling now.
Re: 7/26 Ozy AMPS-195, +3-108, +4-154
we like it when our family members are smiling. You will find that we do consider each other family. We get attached to each others' cats and we support each other through all of life's emotional ups and downs.
we like it when our family members are smiling. You will find that we do consider each other family. We get attached to each others' cats and we support each other through all of life's emotional ups and downs.
donaleen and Ozy
Member Since 2013
Re: 7/26 Ozy AMPS-195, +3-108, +4-154
Okay, I did a +11 and it is up to 347.... that is the third day in a row that the numbers were pretty good all day and then at the last minute went up high like this at the end of the cycle. Does that say anything to you? Is he using up the insulin before the cycle ends?
Okay, I did a +11 and it is up to 347.... that is the third day in a row that the numbers were pretty good all day and then at the last minute went up high like this at the end of the cycle. Does that say anything to you? Is he using up the insulin before the cycle ends?
Re: 7/26 Ozy AMPS-195, +3-108, +4-154 +11 347
I think he's just bouncing from that 108. He could possibly not have quite enough duration but its ok.
We try to ignore the bounce numbers and focus on the blues and greens and the nadirs.
I'd just get a +2 or before bed test. If he's still high, I'd save strips and get some sleep. When he gets to the right dose, you may see some late nights.
I think he's just bouncing from that 108. He could possibly not have quite enough duration but its ok.
We try to ignore the bounce numbers and focus on the blues and greens and the nadirs.
I'd just get a +2 or before bed test. If he's still high, I'd save strips and get some sleep. When he gets to the right dose, you may see some late nights.
Re: 7/26 Ozy AMPS-195, +3-108, +4-154 +11 347
What Ozy's SS tells me is that Ozy sees a blue and he bounces. The bounces are frustrating but they are normal. The more time Ozy spends in blues and greens, the less he will bounce. The good news is that the bounces are clearing quickly. Sometimes, it takes up to 72 hours for a bounce to clear.
What Ozy's SS tells me is that Ozy sees a blue and he bounces. The bounces are frustrating but they are normal. The more time Ozy spends in blues and greens, the less he will bounce. The good news is that the bounces are clearing quickly. Sometimes, it takes up to 72 hours for a bounce to clear.
Deb & Wink
Member Since 2013
Re: 7/26 Ozy AMPS-195, +3-108, +4-154 +11 347
donaleen, you may have skipped over posting in Feline Health first but I want to reassure you that you are in good hands here. We didn't get to cover a lot of the basics over In Health with you for that reason, but the folks here are great and can help you along too.
You are part of the FDMB family now. We support you through "thick and thin" as they say.
You'll do fine over here in the Lantus TR forum with these fine folks.
donaleen, you may have skipped over posting in Feline Health first but I want to reassure you that you are in good hands here. We didn't get to cover a lot of the basics over In Health with you for that reason, but the folks here are great and can help you along too.
You are part of the FDMB family now. We support you through "thick and thin" as they say.
You'll do fine over here in the Lantus TR forum with these fine folks.
donaleen and Ozy
Member Since 2013
Re: 7/26 Ozy AMPS-195, +3-108, +4-154 +11 347
Thank you for your kind words and support.
I do have a queston. If tomorrow is like today for Ozy, do I take his dose up .25 units on the next day (it will be three days at 2.5 by tomorrow night). I read the protocol over and over and it doesn't seem to cover this case. When do you just hold the dose longer than three days?
thank you.
Brief Ozy history:
Ozymandius King of Kings (Ozy) is about 8 or 9 years old and has been with us for four and a half of those years. We got him at the humane society. He was a big beautiful cat (not fat, big), and very fierce (he bit each of us and drew blood before we ever left the humane society). But I just fell in love with him and believed that with time and love, he would be less fierce.
I didn't realize how difficult it would be to take to the vet. Nor did I know he would need a lot of medical attention. He had an autoimmune reaction to a rabies shot. They treated him with prednisalone, which he didn't tolerate very well. He was on it too long and got pancreatitis. He was a difficult patient and it got so they wouldn't examine him without sedation because he was so fierce.
After the first year, I changed to a vet who would come to the house so it wouldn't stress him out so much. He had a lot of symptoms. Breathing issues. Asthma. Diarrhea. Vomiting. Losing weight. Ravenously hungry all the time but unable to eat much. Extreme thirst. Skin lesions in varying places. Constipation. Stiffness and weakness in his back legs. He smelled bad. His coat was often very bad. Lethargy. He was often in the meatloaf position from abdominal pain.
The vet didn’t pick up that some of his symptoms pointed to diabetes and neither did I. Finally I took him for a blood test and learned he is diabetic. His pancreatitis is pretty bad; his fPL number was 19.5. His kidneys and liver are fine. He has some neuropathy in his hind legs. He is a lot healthier than he was before he started insulin. The change is quite amazing already.
Thank you for your kind words and support.
I do have a queston. If tomorrow is like today for Ozy, do I take his dose up .25 units on the next day (it will be three days at 2.5 by tomorrow night). I read the protocol over and over and it doesn't seem to cover this case. When do you just hold the dose longer than three days?
thank you.
Brief Ozy history:
Ozymandius King of Kings (Ozy) is about 8 or 9 years old and has been with us for four and a half of those years. We got him at the humane society. He was a big beautiful cat (not fat, big), and very fierce (he bit each of us and drew blood before we ever left the humane society). But I just fell in love with him and believed that with time and love, he would be less fierce.
I didn't realize how difficult it would be to take to the vet. Nor did I know he would need a lot of medical attention. He had an autoimmune reaction to a rabies shot. They treated him with prednisalone, which he didn't tolerate very well. He was on it too long and got pancreatitis. He was a difficult patient and it got so they wouldn't examine him without sedation because he was so fierce.
After the first year, I changed to a vet who would come to the house so it wouldn't stress him out so much. He had a lot of symptoms. Breathing issues. Asthma. Diarrhea. Vomiting. Losing weight. Ravenously hungry all the time but unable to eat much. Extreme thirst. Skin lesions in varying places. Constipation. Stiffness and weakness in his back legs. He smelled bad. His coat was often very bad. Lethargy. He was often in the meatloaf position from abdominal pain.
The vet didn’t pick up that some of his symptoms pointed to diabetes and neither did I. Finally I took him for a blood test and learned he is diabetic. His pancreatitis is pretty bad; his fPL number was 19.5. His kidneys and liver are fine. He has some neuropathy in his hind legs. He is a lot healthier than he was before he started insulin. The change is quite amazing already.
Deb & Wink
Member Since 2013
Re: 7/26 Ozy AMPS-195, +3-108, +4-154 +11 347
One of the things you may have missed, is the suggestion to always get a 'last test before you go to bed' test. This is because many cats drop lower overnight and if you are not testing at night, you are missing half your data.
Ozy may be bouncing a bit from numbers that his body is not used to. Or he could be dropping lower at night.
With that 'last test before you go to bed' test, it would give us another clue.
I do not think you want to raise his dose yet. You still have 2 more cycles on this 2.5U dose. the depot is still filling and we ask you for your patience to let that happen. I know, I know, it's hard to be patient. You want Ozy better right now! ;-)
If the numbers were all high and flat, we would suggest you increase the dose more rapidly. They are not. You are getting some nice dips in the cycle.
If the number dropped below 50, you would reduce. That is not the situation either.
How do you know if Ozy is ready for another dose increase? By learning how your cat responds to food and insulin, with tests at different times and being patient. "Know thy cat."
He's got a lot of medical issues going on it looks like.
One of the things you may have missed, is the suggestion to always get a 'last test before you go to bed' test. This is because many cats drop lower overnight and if you are not testing at night, you are missing half your data.
Ozy may be bouncing a bit from numbers that his body is not used to. Or he could be dropping lower at night.
With that 'last test before you go to bed' test, it would give us another clue.
I do not think you want to raise his dose yet. You still have 2 more cycles on this 2.5U dose. the depot is still filling and we ask you for your patience to let that happen. I know, I know, it's hard to be patient. You want Ozy better right now! ;-)
If the numbers were all high and flat, we would suggest you increase the dose more rapidly. They are not. You are getting some nice dips in the cycle.
If the number dropped below 50, you would reduce. That is not the situation either.
How do you know if Ozy is ready for another dose increase? By learning how your cat responds to food and insulin, with tests at different times and being patient. "Know thy cat."
He's got a lot of medical issues going on it looks like.
Re: 7/26 Ozy AMPS-195, +3-108, +4-154 +11 347
It would be helpful if you could get a test before you go to bed every night. Those before bed tests can be important. For where Ozy is now, if his nadirs are below 200, you can hold the dose for 5 days. At this point, we only know about his AM cycle nadirs.
I'm not sure what you're seeing that suggests the protocol doesn't apply. If it's a matter of a bounce, we typically suggest that if someone is new to Lantus, you don't increase the dose during a bounce. Since when a bounce clears is unpredictable, if the bounce is clearing, numbers can be coming down with some momentum. If you increase the dose at the same time, there's the potential for a lot of momentum to be behind numbers coming down. If you're comfortably handling dropping numbers, this is less of an issue.
It would be helpful if you could get a test before you go to bed every night. Those before bed tests can be important. For where Ozy is now, if his nadirs are below 200, you can hold the dose for 5 days. At this point, we only know about his AM cycle nadirs.
I'm not sure what you're seeing that suggests the protocol doesn't apply. If it's a matter of a bounce, we typically suggest that if someone is new to Lantus, you don't increase the dose during a bounce. Since when a bounce clears is unpredictable, if the bounce is clearing, numbers can be coming down with some momentum. If you increase the dose at the same time, there's the potential for a lot of momentum to be behind numbers coming down. If you're comfortably handling dropping numbers, this is less of an issue.
donaleen and Ozy
Member Since 2013
Re: 7/26 Ozy AMPS-195, +3-108, +4-154 +11 347
I read it several times and I couldn't figure out what to do when his nadir is 108. That is all. I am reading this page
http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581
It will be six doses tomorrow night. So on Sunday am, I wondered whether to hold the dose or increase it by .25
As for his medical issues, some were cleared by the change to Wellness grain free which happened last fall. His breathing and asthma cleared up. His skin issues abated quite a bit. He hasn't had a really bad pancreatitis attack since we changed his food. He was always on quality canned food (Weruva, Tiki Cat, Wellness,etc), but not grain free and before last fall he got some dry food as well.
The insulin has already made him more engaged and alert and feeling better plus improving his coat, he doesn't stink any more, he isn't so thirsty or ravenous, his legs are more steady, he is more comfortable.
I tested at +1 and will test again tonight at +2
I read it several times and I couldn't figure out what to do when his nadir is 108. That is all. I am reading this page
http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581
It will be six doses tomorrow night. So on Sunday am, I wondered whether to hold the dose or increase it by .25
As for his medical issues, some were cleared by the change to Wellness grain free which happened last fall. His breathing and asthma cleared up. His skin issues abated quite a bit. He hasn't had a really bad pancreatitis attack since we changed his food. He was always on quality canned food (Weruva, Tiki Cat, Wellness,etc), but not grain free and before last fall he got some dry food as well.
The insulin has already made him more engaged and alert and feeling better plus improving his coat, he doesn't stink any more, he isn't so thirsty or ravenous, his legs are more steady, he is more comfortable.
I tested at +1 and will test again tonight at +2
C
Carl & Polly & Bob (GA)
Re: 7/26 Ozy AMPS-195, +3-108, +4-154 +11 347
There's some leeway in the protocol, as doses are suggested being held for 3-5 days. A lot has to do with how aggressive you choose to be. And like Sienne mentioned, you don't want to increase in the middle of a "bounce". It is fairly common in the early days/weeks of treatment that a number like 108 - even though it isn't "low" per se - can trigger a bounce. Just because it's a number that Ozy is no longer used to as being a "normal BG" for cats. If higher numbers are suspected to be caused by a bounce from "low" numbers, then it can be a good idea to wait and see. If it is a bounce, it will run its course and clear.
There's some leeway in the protocol, as doses are suggested being held for 3-5 days. A lot has to do with how aggressive you choose to be. And like Sienne mentioned, you don't want to increase in the middle of a "bounce". It is fairly common in the early days/weeks of treatment that a number like 108 - even though it isn't "low" per se - can trigger a bounce. Just because it's a number that Ozy is no longer used to as being a "normal BG" for cats. If higher numbers are suspected to be caused by a bounce from "low" numbers, then it can be a good idea to wait and see. If it is a bounce, it will run its course and clear.
C
Carl & Polly & Bob (GA)
Re: 7/26 Ozy AMPS-195, +3-108, +4-154 +11 347
All of that is encouraging to read. He's looking and acting like he feels much better. Observations like that are at least as important as the numbers on your meter.
All of that is encouraging to read. He's looking and acting like he feels much better. Observations like that are at least as important as the numbers on your meter.
Re: 7/26 Ozy AMPS-195, +3-108, +4-154 +11-347 PMPS-333 +1-30
Here's the part of the protocol that applies here:
I bolded where you are. He's only got four cycles at this dose. Usually we suggest they once you see blue, you hold for ten cycles unless they earn a reduction.
Here's the part of the protocol that applies here:
I bolded where you are. He's only got four cycles at this dose. Usually we suggest they once you see blue, you hold for ten cycles unless they earn a reduction.
donaleen and Ozy
Member Since 2013
Re: 7/26 Ozy AMPS-195, +3-108, +4-154 +11-347 PMPS-333 +2-30
Thank you. I knew to hold until 6 whole cycles. I wasn't sure what to do after that if his nadir was something in the low 100's. I am fine with holding 10 cycles.
Okay. night time readings (no more room in subject line for updates)
+2 309
+3 276
+5 176
Thank you. I knew to hold until 6 whole cycles. I wasn't sure what to do after that if his nadir was something in the low 100's. I am fine with holding 10 cycles.
Okay. night time readings (no more room in subject line for updates)
+2 309
+3 276
+5 176
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